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Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India

Background: Kawasaki disease (KD) is predominantly seen in young children (<5 years). Diagnosis of KD is often delayed in older children and adolescents, leading to a higher risk of coronary artery abnormalities (CAAs). There is a paucity of literature on KD in older children. Methods: Data were...

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Autores principales: Jindal, Ankur Kumar, Pilania, Rakesh Kumar, Guleria, Sandesh, Vignesh, Pandiarajan, Suri, Deepti, Gupta, Anju, Singhal, Manphool, Rawat, Amit, Singh, Surjit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034337/
https://www.ncbi.nlm.nih.gov/pubmed/32117831
http://dx.doi.org/10.3389/fped.2020.00024
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author Jindal, Ankur Kumar
Pilania, Rakesh Kumar
Guleria, Sandesh
Vignesh, Pandiarajan
Suri, Deepti
Gupta, Anju
Singhal, Manphool
Rawat, Amit
Singh, Surjit
author_facet Jindal, Ankur Kumar
Pilania, Rakesh Kumar
Guleria, Sandesh
Vignesh, Pandiarajan
Suri, Deepti
Gupta, Anju
Singhal, Manphool
Rawat, Amit
Singh, Surjit
author_sort Jindal, Ankur Kumar
collection PubMed
description Background: Kawasaki disease (KD) is predominantly seen in young children (<5 years). Diagnosis of KD is often delayed in older children and adolescents, leading to a higher risk of coronary artery abnormalities (CAAs). There is a paucity of literature on KD in older children. Methods: Data were collated from a review of records of patients diagnosed with KD who were aged ≥10 years at the time of diagnosis, during the period from January 1994 to June 2019. Results: Eight hundred and sixty five patients were diagnosed with KD during this period. Of these, 46 (5.3%; 26 boys and 20 girls) were aged 10 years or older at the time of diagnosis. The median age at diagnosis was 11 years (range of 10–30 years). The median interval between the of fever and the diagnosis of KD was 12 days (range of 4–30 days). Eight patients (17.4%) presented with hypotensive shock. Coronary artery abnormalities (CAAs) were seen in six patients (13.04%), and three patients had myocarditis. Patients with CAAs were found to have significantly higher median platelet counts and higher median C-reactive protein levels. First-line treatment included intravenous immunoglobulin. Adjunctive therapy was given in five patients (infliximab in four patients and steroids in one patient). The median time between the onset of fever and the administration of IVIg was 13.5 days (range of 6–2). The total duration of follow up is 2,014.5 patient-months. Conclusion: Diagnosis of KD in children older than 10 years is usually delayed, and these patients are thus at a higher risk of CAAs.
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spelling pubmed-70343372020-02-28 Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India Jindal, Ankur Kumar Pilania, Rakesh Kumar Guleria, Sandesh Vignesh, Pandiarajan Suri, Deepti Gupta, Anju Singhal, Manphool Rawat, Amit Singh, Surjit Front Pediatr Pediatrics Background: Kawasaki disease (KD) is predominantly seen in young children (<5 years). Diagnosis of KD is often delayed in older children and adolescents, leading to a higher risk of coronary artery abnormalities (CAAs). There is a paucity of literature on KD in older children. Methods: Data were collated from a review of records of patients diagnosed with KD who were aged ≥10 years at the time of diagnosis, during the period from January 1994 to June 2019. Results: Eight hundred and sixty five patients were diagnosed with KD during this period. Of these, 46 (5.3%; 26 boys and 20 girls) were aged 10 years or older at the time of diagnosis. The median age at diagnosis was 11 years (range of 10–30 years). The median interval between the of fever and the diagnosis of KD was 12 days (range of 4–30 days). Eight patients (17.4%) presented with hypotensive shock. Coronary artery abnormalities (CAAs) were seen in six patients (13.04%), and three patients had myocarditis. Patients with CAAs were found to have significantly higher median platelet counts and higher median C-reactive protein levels. First-line treatment included intravenous immunoglobulin. Adjunctive therapy was given in five patients (infliximab in four patients and steroids in one patient). The median time between the onset of fever and the administration of IVIg was 13.5 days (range of 6–2). The total duration of follow up is 2,014.5 patient-months. Conclusion: Diagnosis of KD in children older than 10 years is usually delayed, and these patients are thus at a higher risk of CAAs. Frontiers Media S.A. 2020-02-14 /pmc/articles/PMC7034337/ /pubmed/32117831 http://dx.doi.org/10.3389/fped.2020.00024 Text en Copyright © 2020 Jindal, Pilania, Guleria, Vignesh, Suri, Gupta, Singhal, Rawat and Singh. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Jindal, Ankur Kumar
Pilania, Rakesh Kumar
Guleria, Sandesh
Vignesh, Pandiarajan
Suri, Deepti
Gupta, Anju
Singhal, Manphool
Rawat, Amit
Singh, Surjit
Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India
title Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India
title_full Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India
title_fullStr Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India
title_full_unstemmed Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India
title_short Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India
title_sort kawasaki disease in children older than 10 years: a clinical experience from northwest india
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034337/
https://www.ncbi.nlm.nih.gov/pubmed/32117831
http://dx.doi.org/10.3389/fped.2020.00024
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